Bill > H0863

This bill aims to increase transparency and legislative oversight of payments made to providers under the state's Medicaid program, which provides assistance to people with disabilities. It revises existing law regarding how providers are paid, particularly when there isn't a direct equivalent in Medicare rates. For services like residential habilitation, personal care, and developmental disability services, the state's Department of Health and Welfare will now be required to conduct annual cost surveys, with a portion of responses audited, to inform payment rates. These rates must include allocations for direct care worker wages, employee-related expenses, program costs, and administrative expenses, and providers will be required to spend at least the appropriated amount on direct care and employee expenses, with failure to comply leading to corrective actions. The department must also produce a public report summarizing these audits annually. Additionally, certain administrative rules related to Medicaid benefits will become void by July 1, 2026. The bill emphasizes that all changes to provider payment rates require legislative appropriation and approval.

Health and Social Services

Health and Welfare Committee (House)

https://legislature.idaho.gov/sessioninfo/2026/legislation/H0863/